Hemobilia

Metrics details. Hemobilia is a rare cause of upper hemobilia bleeding.

Kardashian, Nicholas F. LaRusso , James H. Reports of hemobilia date back to the s, but due to its relative rarity and challenges in diagnosis, only in recent decades has hemobilia been more critically studied. A classic triad of right upper quadrant pain, jaundice, and overt upper gastrointestinal bleeding has been described i. Therefore, prompt diagnosis depends critically on having a high index of suspicion, which may be based on a patient's clinical presentation and having recently undergone peri- biliary instrumentation or other predisposing factors. The treatment of hemobilia depends on its severity and suspected source and ranges from supportive care to advanced endoscopic, interventional radiologic, or surgical intervention. Here we provide a clinical overview and update regarding the etiology, diagnosis, and treatment of hemobilia geared for specialists and subspecialists alike.

Hemobilia

Hemobilia is an uncommon source of significant gastrointestinal bleeding resulting from a communication between the vascular and biliary systems. Iatrogenic injury to the liver and the biliary system from percutaneous transhepatic techniques is currently the leading cause of hemobilia. Trauma, operative injury, malignancy, and inflammatory diseases of the hepatobiliary system are other rare, but important, etiologies for clinically significant hemobilia. While diagnostic CT angiography can be used in clinically stable patients, interventional angiography and transcatheter percutaneous endovascular techniques are the standard for diagnosis and treatment of hemobilia. Operative intervention is not required for management in the vast majority of the patients. Appropriate biliary drainage must be ensured after bleeding is addressed. Elizabeth V. Hemobilia is an uncommon source of bleeding resulting from a communication between the vascular and biliary systems. Historically, hemobilia has been associated with the triad of symptoms described by Heinrich Quincke in including pain, gastrointestinal bleeding, and jaundice. We aim to provide a current update, focusing on common patient presentations and modern management strategies. The predominant etiology for hemobilia has changed over time. Historically, hemobilia was associated most commonly with external trauma, both penetrating and blunt.

However, in some cases with massive hemobilia or underlying liver cirrhosis in our study, CBD dilatation was the only cholangiographic feature of hemobilia and there were no filling defects suggesting blood clots in the hemobilia tree, hemobilia. Copy to clipboard, hemobilia. Amebic cysts and hepatic abscesses can be distinguished in the clinical presentation, which classically consists of abdominal pain, hemobilia, and leukocytosis [ 13 ].

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Goal and background: A literature review to improve practitioners' knowledge and performance concerning the epidemiology, diagnosis, and management of hemobilia. Study: A search of Pubmed, Google Scholar, and Medline was conducted using the keyword hemobilia and relevant articles were reviewed and analyzed. The findings pertaining to hemobilia etiology, investigation, and management techniques were considered and organized by clinicians practiced in hemobilia. Results: The majority of current hemobilia cases have an iatrogenic cause from either bile duct or liver manipulation. Blunt trauma is also a significant cause of hemobilia. The classic triad presentation of right upper quadrant pain, jaundice, and upper gastrointestinal bleeding is rarely seen. Computed tomography and magnetic resonance imaging are the preferred diagnostic modalities, and the preferred therapeutic management includes interventional radiology and endoscopic retrograde cholangiopancreatography. Surgery is rarely a therapeutic option. Conclusions: With advances in computed tomography and magnetic resonance imaging technology, diagnosis with these less invasive investigations are the favored option.

Hemobilia

Kardashian, Nicholas F. LaRusso , James H. Reports of hemobilia date back to the s, but due to its relative rarity and challenges in diagnosis, only in recent decades has hemobilia been more critically studied. A classic triad of right upper quadrant pain, jaundice, and overt upper gastrointestinal bleeding has been described i. Therefore, prompt diagnosis depends critically on having a high index of suspicion, which may be based on a patient's clinical presentation and having recently undergone peri- biliary instrumentation or other predisposing factors. The treatment of hemobilia depends on its severity and suspected source and ranges from supportive care to advanced endoscopic, interventional radiologic, or surgical intervention. Here we provide a clinical overview and update regarding the etiology, diagnosis, and treatment of hemobilia geared for specialists and subspecialists alike.

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DOI: Pages July - September CBD, common bile duct. Their long-term durability remains a question due to intimal hyperplasia and associated stent stenosis and possible thrombosis [ 24 ]. Curr Gastroenterol Rep. Among the 14 cases of hepatocellular carcinoma, 2 were treated with lobectomies, 2 were treated with transarterial chemoembolization TAE , 2 were treated with intra-arterial chemotherapy, and 1 was treated with TAE combined with a lobectomy Table 3. Mexico City, Mexico. Typical symptoms in this scenario would be right upper quadrant pain, early satiety, and abdominal bloating [ 13 , 14 ]. In the endoscopic diagnostic of hemobilia was made. West J Med. Am J Gastroenterol, 82 , pp. Sandblom P: Hemobilia. Hepatic artery pseudoaneurysms: a single-center experience. Reprints and permissions.

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Surg Laparosc Endosc , 4: — The development of less traumatic guide-wires and catheters for percutaneous and endoscopic biliary access over the last decade has likely reduced the frequency of iatrogenic hemobilia. Article Google Scholar. Biliary catheter drainage complicated by hemobilia: treatment by balloon embolotherapy. An abdominal computed tomography scan was remarkable for multiple hepatic cysts. At the time the article was last revised Daniel J Bell had no financial relationships to ineligible companies to disclose. Ann Surg , — The cause of hemobilia must be corrected. Tech Vasc Interv Radiol. Issue Date : April Endoscopic retrograde cholangiopancreatographic ERCP removal of obstructing blood clots is initiated. About Recent Edits Go ad-free.